The death of hundreds of thousands of Americans due to the COVID-19 virus has left a wake of grief and psychological struggles not only for the families of victims but also some of the health care personnel who relentlessly provided care and watched many succumb to the virus. Phelps Health in Missouri is among the countless health systems who have been affected by COVID-19 both with the influx of patients and staff coping with Second Victim Syndrome.

Second Victim Syndrome, once applied to negative psychological effects that health care providers feel because of their involvement with an error in a patient’s care, has been expanded to include clinician reactions to their involvement in crisis situations where patients die like the COVID-19 crisis.

Phelps Health, a rural health system serving six counties in the south-central area of the state, ramped up its HEAL (Helping Employees After Loss) Program as the virus began spreading inland from the United States coasts.

“In rural Missouri, we did not see it happen here until a little later,” said Natalie Turnbough, MSW, CCM, Care Manager MSW, Denial Prevention & Recovery, Phelps Health. “While everything was shutting down in March, we did not see a case until June, and our staff began feeling anxiety because they just wanted to get it going and get it done.”

Formed in 2014, the HEAL Team at Phelps Health received training from the University of Missouri to help staff cope with unexpected and stressful events through crisis support and stress management. The team consists of volunteers including physicians, nurses, respiratory therapists, social workers and chaplains.

While the HEAL Team existed prior to COVID-19, it was often forgotten unless a member of the team would hear about someone who needed help by word of mouth. That changed with the onset of the pandemic.

“Our communication evolved, and we re-educated staff about how we could help them,” said Heather L. Witt, MOL, LSSGB, HR Business Partner, Human Resources, Phelps Health. “We increased the awareness of the HEAL Team to let people know we were here and began a proactive campaign by giving staff tips for self-care by exercising and getting the right nutrition in their body.”

The HEAL Team began making rounds to staff to bring awareness of their services and providing a healthy snack like popcorn, fruit and water from a food cart. They also distributed education sheets and listened to their co-worker’s concerns.

The early efforts seemed to offer the support that staff needed, but the pandemic continued and reached a climatic time of stress between Thanksgiving 2020 and January 2021. Schools were shutting down in the area, and everyone seemed to have a loved one who succumbed to the virus.

“We had administrators, managers and other staff who had lost a parent,” Turnbough said. “Everyone seemed to know someone who had lost someone. Our people had to cope with personal loss at home and then come to work and manage COVID-19 cases.”

The HEAL Team volunteers became a team of listeners, sometimes shedding tears with their fellow staff, and then discussing next steps to help them cope. This included making time to talk again in the future or even being referred to free visits to the health system’s Behavioral Health Clinic, if necessary.

While the vaccine is now in play and infection numbers are beginning to drop, the rounding continues. In July, executives asked clinician team leaders to clear their calendars from 8 to 10 a.m. to begin making these rounds and focus of the mental well-being of staff. The support between colleagues helps, Turnbough said, even though sometimes a person making rounds may have just enough time to stuff a snack in the pocket of a busy co-worker.

“We have heard several comments like, ‘I think God sent you here today because I needed to see you,’” Turnbough said. “We also have people who stop us if we are just walking by and they ask, ‘Where is your cart?’”